| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
10,895 |
8,550 |
$395K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,129 |
2,441 |
$155K |
| T1015 |
Clinic visit/encounter, all-inclusive |
10,623 |
6,489 |
$66K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
2,474 |
1,871 |
$63K |
| D1110 |
Prophylaxis - adult |
1,524 |
1,138 |
$55K |
| G0467 |
Federally qualified health center (fqhc) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a fqhc practitioner during which time one or more fqhc services are rendered and includes a typical bundle of medicare-covered services that would be furnished per diem to a patient receiving a fqhc visit |
1,454 |
1,000 |
$34K |
| D9999 |
Unspecified adjunctive procedure, by report |
3,396 |
2,056 |
$32K |
| D0120 |
Periodic oral evaluation - established patient |
1,123 |
821 |
$19K |
| D0330 |
Panoramic radiographic image |
400 |
330 |
$18K |
| D0274 |
Bitewings - four radiographic images |
644 |
445 |
$15K |
| D0150 |
Comprehensive oral evaluation - new or established patient |
357 |
319 |
$14K |
| 98941 |
Chiropractic manipulative treatment; spinal, 3-4 regions |
400 |
114 |
$10K |
| 99396 |
Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years |
88 |
65 |
$8K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
83 |
68 |
$4K |
| 97140 |
Manual therapy techniques, each 15 minutes (e.g., mobilization/manipulation, manual lymphatic drainage) |
505 |
92 |
$3K |
| 87635 |
Infectious agent detection by nucleic acid; SARS-CoV-2 (COVID-19), amplified probe |
85 |
60 |
$3K |
| D7140 |
Extraction, erupted tooth or exposed root |
31 |
13 |
$2K |
| 80305 |
|
282 |
246 |
$2K |
| D1120 |
Prophylaxis - child |
47 |
47 |
$2K |
| Q3014 |
Telehealth originating site facility fee |
116 |
91 |
$1K |
| D0140 |
Limited oral evaluation - problem focused |
26 |
24 |
$956.60 |
| D1206 |
Topical application of fluoride varnish |
47 |
47 |
$953.28 |
| D0210 |
Intraoral - complete series of radiographic images |
26 |
26 |
$883.62 |
| 98940 |
|
59 |
12 |
$856.67 |
| 87880 |
Infectious agent antigen detection by immunoassay; Streptococcus, group A |
166 |
148 |
$743.20 |
| 99406 |
|
67 |
43 |
$557.48 |
| 90686 |
|
30 |
24 |
$468.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
51 |
46 |
$405.83 |
| D2392 |
Resin-based composite - two surfaces, posterior, primary or permanent |
15 |
12 |
$385.58 |
| 90756 |
|
70 |
68 |
$315.00 |
| 82274 |
|
37 |
20 |
$297.86 |
| 81003 |
|
469 |
356 |
$153.43 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
86 |
81 |
$119.43 |
| 99401 |
|
718 |
514 |
$0.00 |
| 81007 |
|
287 |
249 |
$0.00 |
| 81002 |
|
24 |
24 |
$0.00 |
| 3008F |
|
20 |
18 |
$0.00 |
| G9226 |
Foot examination performed (includes examination through visual inspection, sensory exam with 10-g monofilament plus testing any one of the following: vibration using 128-hz tuning fork, pinprick sensation, ankle reflexes, or vibration perception threshold, and pulse exam; report when all of the 3 components are completed) |
30 |
14 |
$0.00 |
| 3351F |
|
16 |
15 |
$0.00 |